Tips for Morning Sickness

by Angel J. Miller, MSN, CNM

Nausea, with or without vomiting, is known as “morning sickness” but may occur any time of the day or night. Although we do not know exactly why women experience morning sickness, some thoughts are:

• hormonal changes during pregnancy
• low blood sugar
• gastric overload
• slowed movement of the intestines
• enlarged uterus
• emotional factors

Take heart! In most cases morning sickness goes away by the 14th week of pregnancy.

Try the following comfort measures to ease the symptoms:

 Eat small, frequent meals (5-6 a day or on the average of every 2 hours)
• Avoid foods that do not have an appealing smell or taste to you at the time. Eat whatever sounds good. Let someone else do the cooking!
• Avoid strong or offensive odors, spicy, fried or greasy foods
• Restrict fat intake

 Dry crackers, cereal or bread—every time you are up to pee at night and first thing in the morning.
• On bad days, have crackers at the bedside even before getting/sitting up

 Drink or sip ice cold beverages. Some women do better just sucking on ice, and some do better when they add a splash of lemon juice to their cold water.
• Do not drink fluids with meals, do so after
• Do not drink large amounts of fluids at one time; sip on small amounts frequently between meals

 Eat a protein snack just before going to bed, such as cheese & crackers, or peanut butter & toast.

Stop your vitamins and iron supplements (temporarily) if you think they are adding to your morning sickness problem, or try taking the vitamin at bedtime with a snack.

Take a vitamin B6 (pyridoxine) tablet-30-50mg, 3 to 4 times a day-every day initially, then 1-2 times per day until problem has subsided
• Ovaltine is enriched with vitamin B6
• Another suggestion is to take Unisom (doxylamine) 1 tablet
(25 mg) at bedtime-with the vitamin B6. In the morning take ½ a tablet (with the B6). At 2 pm, ½ tablet with vitamin B6. Ask your pharmacist to help you find this medication. It is available over-the-counter and some brands are less expensive that others. In order for this to help, you need to take it regularly not just when you feel sick.

• Or you can take Vitamin B6, 100mg, po, three times a day with Magnesium 500mg, po, twice a day

Sea-Bands (seasickness prevention wrist bands) which are available at most drug stores help many women. Some women swear by them, and others do not find them helpful

• Take ginger. You can find this spice in the health food or vitamin stores. Get the 250 mg capsules. Take one capsule 4 times each day, or try nibbling on ginger snap cookies, sip on ginger tea
• Papaya or papaya tablets, as directed on the bottle
• Suck on fireballs or lemon balls; chewing cinnamon gum
• Alfalfa tablets—2 at bedtime, 2 late in day
• Basil, chamomile, spearmint, or peppermint tea

DO NOT SKIP MEALS EVEN IF YOU ARE NAUSEATED OR HAVE NO APPETITE! Graze…

If these suggestions do not work ask your health care provider about prescription medications that are available. They can make you sleepy; therefore it is wise to try the other remedies first.

**If you ever find that you are among the very few who are unable to keep anything down for 48 hours (even liquids) give us a call. In these extreme cases we recommend that you come into the hospital for IV fluid therapy.

Importance of Oral Health During Pregnancy

“Why do my gums bleed so much and so easily?” Oral health is a key component of overall optimal health and wellbeing across a person’s lifespan. During the course of pregnancy, it is very important to obtain treatment for your oral health and it IS safe throughout pregnancy. It is very surprising to find out that 22% of U.S. women reported they never accessed oral health care prior to becoming pregnant, and less than one third of pregnant moms visited their dentist in the postpartum period (between 2 to 9 months postpartum) following the birth of their babies. These statistics were obtained in a 2004 study. Surprising? Yes. Can it be prevented? Absolutely!

Why is oral health so important, especially during pregnancy? The many physiological changes that a woman’s body undergoes during pregnancy can have an undesirable affect on her overall oral health and good oral hygiene. The many hormonal changes that occur in pregnancy can increase the risk of the pregnant mom to be more susceptible to oral infections, such as periodontal disease, and can reduce the body’s ability to repair soft tissues in the mouth. In addition, “pregnancy gingivitis” or mild inflammation of the gums occurs in approximately 60% to 75% of pregnant women. If this condition is left untreated, it can lead to periodonitis, which can lead to bone and tooth loss. Periodontal disease has been associated with cardiovascular disease, stroke, poor diabetes control and adverse birth outcomes. The pain that results from oral disease can also harm nutritional intake and affect a pregnant woman’s self esteem.

While oral health is important to a women’s overall health, her oral health is also important in its relationship to the health of her unborn child. Studies have shown an association between periodontal disease and adverse birth outcomes such as low birth weight, preterm birth and gestational diabetes. More importantly, transmission of bacteria from the mother to her baby is the primary way that children first acquire the disease that causes cavities. Evidence suggests that most infants and most children acquire caries-causing bacteria from their mothers. Cavity-causing bacteria is passed through saliva via activities like sharing utensils, wiping off the baby’s pacifier in the mother’s mouth, and testing food before feeding to your baby. The healthier mom’s mouth, and the longer the initial transmission of bacteria is delayed, the more likely children are to establish and maintain good oral health.

Tips to help promote oral health:
• To help prevent or control tooth decay, brush your teeth with fluoridated tooth paste twice/day, and FLOSS DAILY
• Eat fruit, veggies, whole grain products and dairy products. Limit foods containing sugar to meal times only (watch those carbs!!)
• Drink plenty of water or low-fat/skim milk. AVOID carbonated beverages
• Choose fruit rather than fruit juice to meet the recommended daily intake of fruit (and will have less sugar)
• Obtain necessary oral treatment ideally before pregnancy. Those who have bleeding gums or cavities, should visit a dentist as soon as possible
• Diagnosis (including necessary dental x-rays) and treatment can be provided throughout pregnancy; however, the period between weeks 14 and 20 weeks of pregnancy is the best time to receive treatment.• Delaying necessary treatment could result in significant risk to the mother and indirectly to her baby

If you are dealing with morning sickness or frequent nausea, especially in the first trimester, here are some tips:
• Eat small amounts of nutritious foods throughout the day: the 6 small meals a day rule is important throughout pregnancy, but especially for dealing with nausea
• Chew sugarless or xylitol gum (causes bacteria to lose the ability to adhere to the tooth, stunting the cavity causing process) after meals.
• Rinse your mouth with water and a teaspoon of baking soda (sodium bicarbonate) after vomiting to neutralize acid
• Gently brush teeth with fluoridated toothpaste twice a day to prevent damage to demineralized tooth surfaces
• If you can’t brush your teeth because you feel sick, rinse your mouth with water or a mouth rinse that has fluoride

POSTPARTUM
For mom:
• Maintain good oral health
• Limit foods containing sugar to meal times only (watch sugar intake overall)
• Avoid saliva-sharing behavior, including:
Sharing spoons or other utensils
Cleaning a dropped pacifier or toy by putting it in your mouth

For Baby:
• After the first tooth erupts, wipe your baby’s teeth after feeding with a soft cloth or soft-bristled toothbrush
• Avoid putting your baby to bed with a bottle or sippy cup containing anything other than water
• Ask your baby’s healthcare provider about your baby’s oral health status
• Schedule your baby’s first dental visit for between ages 6 and 12 months

Promoting oral health during pregnancy is the solution to achieving overall health and well-being for pregnant women, their babies and families. Visit your dentist regularly and maintain good oral hygiene.

Article by Jessie Buerlein, MSW, Project Mgr, presented by Angel J. Miller, MSN, CNM
Quickening, Summer 2009. Volume 40, Number 3
Official Newsletter of the American College of Nurse Midwives

Submitted by the Improving Perinatal and Infant Oral Health Project, a joint effort of the American Academy of Pediatric Dentistry and the Children’s Dental Health Project. For more info please visit http://www.cdhp.org